Kempke, Stefan, Van Houdenhove, Boudewijn, Luyten, Patrick et al. · Psychiatry research · 2011 · DOI
This study looked at perfectionism in ME/CFS patients and found that there are two different types: one that involves setting high personal standards (which wasn't harmful) and another involving excessive worry about mistakes and self-doubt (which was harmful). The harmful type of perfectionism was linked to worse fatigue and depression symptoms. Interestingly, depression appeared to be the main pathway through which this harmful perfectionism made fatigue worse.
Understanding that harmful perfectionism (not all perfectionism) contributes to worse ME/CFS outcomes has important implications for psychological interventions like cognitive-behavioral therapy, potentially offering a modifiable treatment target. This distinction helps patients and clinicians recognize that the problem isn't having high standards, but rather excessive self-criticism and doubt, which may be more amenable to therapeutic intervention.
This study cannot prove that maladaptive perfectionism causes fatigue or depression—it only shows they are associated. The cross-sectional design means we cannot determine whether perfectionism leads to worse symptoms, worse symptoms lead to perfectionism, or both are caused by another factor. The study also does not address whether treating perfectionism would actually improve ME/CFS outcomes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Kempke, Stefan, Van Houdenhove, Boudewijn, Luyten, Patrick, Goossens, Lutgarde, Bekaert, Patrick, & Van Wambeke, Peter (2011). Unraveling the role of perfectionism in chronic fatigue syndrome: is there a distinction between adaptive and maladaptive perfectionism?. Psychiatry research. https://doi.org/10.1016/j.psychres.2010.09.016
BibTeX
@article{mecfsatlas-kempke-2011-unraveling-role,
author = {Kempke, Stefan and Van Houdenhove, Boudewijn and Luyten, Patrick and Goossens, Lutgarde and Bekaert, Patrick and Van Wambeke, Peter},
title = {Unraveling the role of perfectionism in chronic fatigue syndrome: is there a distinction between adaptive and maladaptive perfectionism?},
journal = {Psychiatry research},
year = {2011},
doi = {10.1016/j.psychres.2010.09.016},
note = {PubMed: 20961622},
url = {https://www.mecfsatlas.com/evidence/kempke-2011-unraveling-role},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/kempke-2011-unraveling-role
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